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Biomedical subjects

L Glickman

Publications and source records attributed to L Glickman.

At least 19 recordsLinked to original sources

Time trends and risk factors for diabetes mellitus in dogs: analysis of veterinary medical data base records (1970-1999).

The objectives of the study were to identify recent trends in the prevalence of diabetes mellitus (DM) in dogs and to identify host risk factors. Veterinary Medical Data Base (VMDB) electronic records of 6860 dogs with a diagnosis of DM (VMDB code 870178500) between 1970 and 1999 were evaluated to determine time trends. Records of 6707 dogs with DM and 6707 frequency matched dogs with any diagnosis other than DM from the same teaching hospitals in the same year, selected as controls, were evaluated for risk factor analysis. The prevalence of DM in dogs presented to veterinary teaching hospitals increased from 19 cases per 10,000 admissions per year in 1970 to 64 cases per 10,000 in 1999, while the case-fatality rate decreased from 37% to 5%. The hospital prevalence of DM was consistently greater over time in older compared with younger dogs with the highest prevalence occurring in dogs 10-15 years of age. Dogs weighing <22.7 kg had a significantly (P<0.001) greater risk of DM compared with heavier dogs. Female dogs had an increased risk of DM compared with males (P<0.001).

Animals↗

Extracellular Bartonella henselae and artifactual intraerythrocytic pseudoinclusions in experimentally infected cats.

Blood, spleen and liver of specific pathogen-free (SPF) cats and SPF cats experimentally infected with Bartonella henselae were examined. Using immunohistochemical labeling, no intracellular B. henselae were observed in tissues of any cats, but extracellular B. henselae were detected in tissues of infected cats. Pseudoinclusions were detected in erythrocytes of all cats using electron microscopy.

Animals↗

Effects of human intravenous immunoglobulin on canine monocytes and lymphocytes.

OBJECTIVE: To evaluate interactions of human intravenous immunoglobulin (IVIG) with canine lymphocytes and monocytes. SAMPLE POPULATION: Heparinized blood samples from 4 clinically normal Beagles. PROCEDURE: Binding ability of IVIG to canine lymphocytes and monocytes was measured by flow cytometry and an indirect immunofluorescent assay. Dual-staining fluorescent assays were done to determine lymphocyte subsets that bind IVIG. Competitive assays were done, using intact canine IgG and Fc fragments, and inhibition of binding was compared with that of F(ab)2 fragments. Ability of IVIG to inhibit phagocytosis of antibody-coated canine RBC also was determined, using a canine mononuclear cell phagocytic assay. RESULTS: IVIG concentrations (10, 1, 0.1, and 0.01 mg/ml) bound to (mean+/-SD) 99.6+/-0.4, 92.4+/-6.1, 20.4+/-24.6 and 2.0+/-5.1 % of canine lymphocytes, respectively, Dual staining analyses with IVIG and canine lymphocyte markers indicated that IVIG bound to CD4, CD8, and B lymphocytes. The aforementioned 4 IVIG concentrations bound to 98.0+/-2.1, 85.5+/-13.5, 64.7+/-32.8, and 26.5+/-17.1 % of monocytes, respectively. Inhibition of IVIG (0.01 mg/ml) binding to monocytes was significant (P< 0.05) in the presence of 1 and 10 mg of canine IgG/ml and 1 mg of canine Fc fragments/ml. In the presence of F(ab')2 fragments of canine IgG, inhibition was not significant, suggesting that binding is Fc mediated. Co-culturing of monocytes, opsonized RBC, and the 4 concentrations of IVIG and no IVIG resulted in 11.8+/-5.1, 27.7+/-12.3, 31.8+15.1, 53.8+/-6.7, and 45 + 12% of the monocytes containing RBC, respectively. Phagocytosis inhibition was significant (P < 0.05) at an IVIG concentration of 10 mg/ml. CONCLUSIONS: IVIG binds to canine lymphocytes and monocytes; binding to the latter is Fc mediated. IVIG also inhibits Fc-mediated phagocytosis of antibody-coated RBC. CLINICAL RELEVANCE: Owing to its ability to inhibit Fc-mediated phagocytosis of antibody-coated RBC, IVIG may be an effective short-term treatment for dogs with immune-mediated hemolytic anemia.

Animals↗

Use of the urine cortisol: creatinine ratio to monitor treatment response in dogs with pituitary-dependent hyperadrenocorticism.

OBJECTIVE: To determine the usefulness of measuring urine cortisol:creatinine ratio (UCCR) as a means of monitoring response to mitotane treatment in dogs with pituitary-dependent hyperadrenocorticism (PDH). DESIGN: Case series. ANIMALS: 51 clinically normal dogs and 21 dogs with PDH. PROCEDURE: The reference range for the UCCR was determined by measuring the ratio in 51 clinically normal dogs. The usefulness of measuring UCCR in evaluating response of 21 dogs with PDH to treatment with mitotane was evaluated by comparing ACTH-stimulated blood cortisol concentrations with UCCR at the end of the induction phase of treatment (13 dogs) and during the maintenance phase of treatment (21). RESULTS: UCCR was not useful for identifying dogs with inadequate adrenal reserves at the end of the induction phase of treatment or during the maintenance phase. The UCCR was useful for identifying dogs in which control of cortisol secretion was not adequate. CLINICAL IMPLICATIONS: UCCR should not be used for evaluation of dogs during the induction phase of treatment, because the potential consequences of not identifying dogs with inadequate adrenal reserves are great. The UCCR may be useful as an adjunct means of monitoring treatment response during the maintenance phase of treatment. However, the ACTH stimulation test remains a necessary component when monitoring response to treatment in dogs with PDH receiving mitotane.

Adrenocortical Hyperfunction↗

Incidence of extrapyramidal syndromes in AIDS patients and a comparison group of medically ill inpatients.

The authors retrospectively reviewed the charts of 29 inpatients with AIDS and 24 medically ill inpatients, all of whom were exposed to neuroleptics. Results adjusted for age, gender, type and dosage of neuroleptic, and extrapyramidal prophylaxis indicated that inpatients with AIDS were 7 times more likely to develop extrapyramidal syndromes (EPS) from neuroleptics than the comparison group of medically ill inpatients. Possible neuroanatomic, neuropathologic, and neurochemical reasons for the vulnerability of patients with AIDS to EPS are reviewed.

Acquired Immunodeficiency Syndrome↗

Physicians' knowledge of drug costs for the elderly.

OBJECTIVE: To measure physicians' knowledge of the costs of commonly used medications in geriatric practice and how such awareness influences their prescribing decisions. DESIGN: A survey of pharmacies to determine the prices of 14 commonly used brand name and generic drugs and an in-person survey of physicians asking them to price these drugs. SETTING: Eastern Massachusetts. PARTICIPANTS: One hundred thirty-two primary care practitioners were surveyed during hospital rounds and medical society meetings. MEASUREMENT: The study examined physician awareness of patients' ability to afford drugs, the use of generic drugs, clinical decision-making practices, and the physicians' level of knowledge of drug costs. Actual drug prices were measured by surveying 22 pharmacies. RESULTS: Of the 132 respondents, 85% reported that inability to afford medications was a problem for some of their patients. One in five indicated that they did not believe generic drugs to be as safe or effective as brand name drugs, and 30% reported that they rarely or never had access to information about drug costs. Of the 99 physicians who estimated drug prices, there was a marked trend toward underestimation of the prices of more expensive drugs as well as overestimation of the prices of less costly drugs. Physician estimates of prices were highly variable; their estimates were much more variable than pharmacy prices. Younger physicians were more likely than older physicians to make correct estimates, and specialists in internal medicine were less likely to make correct estimates than physicians in other specialties. CONCLUSIONS: These data indicate that substantial knowledge deficits exist in physicians' understanding of the economic implications of the prescriptions they write. Considerable educational activity will be necessary in this area if clinicians are to function as cost-effective prescribers under health care reform.

Aged↗

Follow-up study of owner attitudes toward home care of paraplegic dogs.

A questionnaire was mailed to 30 owners of paraplegic dogs who had been caring for their dogs at home for 3 to 72 months. It was designed to collect information on demographic variables, duration of ownership and paralysis, age of the pet, pet/owner relationship, owner expectations and perceptions of the pet's quality of life, problems the pet experienced, effect that maintaining a paralyzed pet had on the owners' quality of life, and whether use of a cart was beneficial. Significant correlation was found between prior expectations that the pet would lead a high-quality life and perception that the pet, in fact, had a high quality of life during paralysis (r2 = 0.61, P = 0.01). Owners who had anticipated that extra work would be necessary to care for their paraplegic dog had a more positive attitude toward home care (r2 = 0.55, P = 0.03). Overall, owners involved in the study were satisfied with all aspects of maintaining paraplegic dogs at home. Our findings support the feasibility of dedicated owners successfully maintaining small (average body weight, 9 kg) paraplegic dogs at home for extended periods.

Age Factors↗

Reasons for requests for evaluation of competency in a municipal general hospital.

During the period from July through September 1989, 380 referrals to a psychiatry consultation-liaison service were reviewed. Of these patients, 25% were referred for a determination of competency, despite the fact that they often showed no evidence of mental illness. Seventy-five percent of the patients were found to be competent. Fear of medical legal consequences, physician's anxiety, lack of understanding of the rights of patients to refuse treatment, and a misunderstanding of the physician's duty when presented with such refusal seem to be the reasons for the large number of referrals.

Adolescent↗

The measurement of cold sensitivity of the hand.

There is no widely accepted method of measuring the severity of cold sensitivity of the hand. A patient-answered questionnaire was developed. This consisted of seven items divided into two subscales: the first to measure the severity of cold sensitivity, and the second to grade exposure of the hands to cold at the workplace. The test-retest reliability was 0.92 for the severity subscale and 0.94 for the work exposure scale. An initial test of validity supports the use of the scale to measure cold sensitivity of the hand.

Adult↗

Fall-off in reporting life events: effects of life change, desirability, and anticipation.

The influence of event characteristics on recall was examined by directly comparing fall-off in reporting life events as a function of life change, desirability, and anticipation. We collected information from a sample of 1,669 blue-collar workers on stressful life events that occurred in a 1-year interval before the questionnaire was administered. The results indicated no fall-off in reporting events associated with marked life changes (ie, salient events). In contrast, significant fall-off was observed for events characterized by varying degrees of desirability and anticipation. Although ratings of desirability and saliency were not independent, saliency of life events emerged as the dimension most closely associated with accuracy of event reporting. Research on the reliability of measures of life events and the association between event characteristics and illness should consider the kinds of systematic reporting differences observed here.

Aged↗

Toxocara canis infection of children: epidemiologic and neuropsychologic findings.

Sera from 4,652 children whose blood was submitted to the New York City Department of Health for lead analysis were tested for antibodies to Toxocara canis using an enzyme-linked immunosorbent assay (ELISA). Standardized to the age distribution of the study population, T. canis seropositivity (inverse titers greater than or equal to 16) was 5.7 per cent in males and 5.1 per cent in females. T. canis antibody titers and lead exposures as measured by Centers for Disease Control lead classes were positively correlated. Children who were seropositive to T. canis (cases) were compared to seronegatives (controls) matched on age (+/- 6 months), sex, time-of-screening (+/- 3 months) and CDC lead class. Logistic regression analysis of 155 case-control pairs demonstrated elevated relative risks (RRs) for geophagia (RR = 3.14; 95% CI = 1.75, 5.64) and having had a litter of puppies in the home (RR = 5.22; 95% CI = 1.63, 16.71). Compared to controls, cases had increased eosinophil counts, serum immunoglobulin E concentrations, and anti-hemagglutinin-A titers. Small deficits in cases compared to controls were found in performance on several neuropsychological tests after adjustment for potential confounders including case-control differences in race, socioeconomic status, and current blood lead concentrations. The study thus confirmed that T. canis infection is common in urban children and suggested that infection may be associated with adverse neuropsychological effects.

Adolescent↗

Saccadic eye movements among copper smelter workers.

Saccade accuracy was studied in 87 copper smelter workers. Findings were compared with those obtained in 52 lead-exposed automobile production workers and 52 controls examined as part of a separate study. Both groups of workers showed a decrease in saccade accuracy compared to controls. Saccade accuracy was reduced in copper smelter workers over 50 years of age compared to automobile production workers in this age group. Decreased saccade accuracy was not correlated with blood lead (Pb-B), zinc protoporphyrin (ZPP), or urinary arsenic (As-U) levels among copper smelter workers, but was significantly correlated with both Pb-B and ZPP in the group of automobile production workers. Saccade accuracy decreased significantly with age and duration of exposure only in the group of copper smelter workers. Complex exposures to lead and other toxic agents present in the smelter may account for the reduction in saccade accuracy among copper smelter workers.

Adolescent↗